Women in medicine—diversity and the glass ceiling

International Women’s Day is celebrated in March, and despite the progress made since this day was named 110 years ago to highlight work toward equal rights for women, significant disparities still exist.

I entered medical school at a time when women were still a minority—just 30% of my classmates were women. My first rural practice elective after my second year of medical school was in an entirely male clinic. They had recently hired a new colleague and I asked if they had considered any women. “Oh no,” they said. “Our community is not ready for a woman physician.” Interestingly, 2 weeks after I started fumbling my way through clinical medicine, a number of patients called the clinic wanting to make appointments with “that new lady doctor” in town! And again, when I began practice I was the only woman in my clinic. I can still remember the look on the face of the older gentleman who was there for a complete exam as I walked into the exam room. I think he might have bolted if not for the fact that he was already in the flimsy exam gown. I ignored his panic and we got through the process. He even made a follow-up appointment, so I guess it went okay.

I encountered a fair amount of gender bias throughout my clerkship and internship, but I think we all expected it because we were women breaking new ground in a traditionally male-dominated field. I certainly experienced subtle and not-so-subtle questioning of my competence and career potential from attending physicians and, sadly, not always from men. In some instances it was hard to figure out if it was because I was a woman or just because I was a trainee.

My response was to work harder and longer and prove I was just as competent as any man. When pregnant with my first child I planned to work until delivery and take minimal time off, basically to prove my gender would not disadvantage the group. As often happens, my plan was thwarted. I developed pneumonia at 32 weeks, wound up hospitalized, then went through a bout of preterm labor—all to say that my plans to work until I delivered were obliterated. My group cov-ered my call, saw my patients, delivered my maternities, and helped me juggle all my responsibilities. Quite frankly, if not for their actions I would have ended my rural medical career. Because of my experiences during training, I was trying hard to prove myself to a group that, as it turned out, actually valued my contribution because I was the only woman in the practice.

Medicine has come a long way since then. It’s been 30 years and my clinic is now more than half women. I don’t think my community has even noticed. There are probably more folks now who would rather see a female doctor, which bothers me just the same as when folks refused to see me because I am female. Today’s medical schools, both in Canada and the US, have more women than men. Of family doctors under 40, more than half are women. And yet, significant barriers still exist for advancement, particularly in certain specialties, academic medicine, leadership, and medical politics.

I am the seventh female president of Doctors of BC. For an organization that was founded in 1900, we are not exactly at the forefront of visible female physician leadership. You may presume that having achieved this position I would find gender bias to be less prevalent. Not so. I have been astounded at the situations where others are visibly surprised to find a woman in this position, and even more surprised when I make a valuable contribution.

I believe that, although gender differences exist, there should be equal professional opportunities for all genders. Sadly we have a very long way to go to meet this goal. Our Board remains predominantly male, although we have a somewhat better balance on the Representative Assembly. I encourage more women to stand up and be involved in Doctors of BC committees, your division of family practice, or medical staff association. Become a leader in an area you feel passionate about, whether in your association or in your community. And most of all, own your success. Don’t let anyone make you feel that you don’t deserve what you have worked hard for.

I realize there are other differences that need to be addressed. Organizational cultural change is frustratingly slow. We are actively striving to balance not just gender but age, stage, and type of practice on our committees. Multicultural diversity must be considered as well. Given that Doctors of BC is an advocacy group for the profession, we need to promote diversity throughout the medical community. We can begin by addressing our own organization and leading by example. Let us continue to advocate for a medical profession that is truly inclusive with equal rights and opportunities for all.—Trina Larsen Soles, MDDoctors of BC President